Príloha č. 5

CONFIDENTIAL		Case No: MS/XX/XXX/PH/X1

QUARTERLY COMMUNICATION OF IRREGULARITIES IN CONNECTION WITH THE IMPLEMENTATION OF THE PHARE NATIONAL PROGRAMME, AS REQUIRED BY THE FINANCING MEMORANDUM

IDENTIFICATION OF COMMUNICATION

Applicant Country:
Case Number: XX/XX/XXX/PH/X1
Quarter: XX/XX2
Date Sent:
Administrative Department in Applicant Country:
Contact Point:  	Name:				Phone:	
 			Fax:				e-mail:

DETAILS OF IRREGULARITY

1. Description of Operation

1.1 Name of programme: 

1.2 Commission Decision approving the project:

1.3 Name of measure and title of project: 

1.4 Applicant country’s project number:

2. Provision Infringed

2.1 Community provision infringed:

2.2 National provision infringed:

3. Date of First Information Leading to Suspicion of Irregularity:

3.1 Source of first information leading to suspicion of irregularity:

4. Manner in Which Irregularity was Discovered:

5. Type of Irregularity

5.1 Practices employed in committing the irregularity:

5.2 Are these practices considered new?	Yes (  )		No (  )

6. Are Other Countries Involved?		Yes (  )		No (  )

6.1 If yes, has notification been sent to the respective counties?

Yes (  )     Date and reference:		No (  )		Not Known (  )

7. Period of Irregularity

7.1 Date on which, or dates between which, the irregularity was committed:

8. Authorities or Bodies

8.1 Authorities or bodies which drew up the official report on the irregularity:

8.2 Authorities or bodies responsible for administrative or judicial follow-up:

9. Date on Which the Official Report on the Irregularity was Drawn up:

10. Name and Address of Natural and Legal Persons Involved

10.1 Natural Persons:

- Name:
- First Name:
- Address:
- Postal Code:
- City:
- Country:
- Function:

10.2 Legal Persons:

- Name:
- Registered Office:
- Postal Code:
- Country:

FINANCIAL ASPECTS

11. Total Amount and Distribution Between Sources of Financing

11.1 Total amount of the operation:

11.2 Community financing: 

11.3 Applicant country financing:

12. Nature and Amount of the Expenditure Found to be Irregular

12.1 Nature of the expenditure:

12.2 Total amount of the expenditure:

12.3 Community expenditure:

12.4 Applicant country expenditure:

13. Amount which would have been wrongly paid if the Irregularity had not 
      been discovered

14. Financial consequences

14.1 Amount of expenditure under 12.2 not yet paid:
      
        Amount EU:   	  			
      
        Amount applicant country:

15. Possibility of Recovery:

16. Total Amount Recovered:

16.1 Community share:

16.2 Applicant country share:

17. Total Amount to be Recovered:

17.1 Community share:

17.2 Applicant country share:

STAGE OF PROCEDURES

18. Action by Applicant Country

18.1 Interim measures:

19. Administrative Proceedings:

20. Judicial Proceedings:

21. Reasons for any abandonment of recovery proceedings:

21.1 Was the Commission notified before the decision to abandon the recovery 
        procedure was taken?

Yes ( )   date and references,      	No ( ) 	 			Not Known ( )

22. Have criminal proceedings been abandoned?

Yes ( )   				No ( ) 				Not Known ( ) 

23. Termination of Procedures

23.1 Has the Commission been notified of administrative or judicial decisions or the 
       main points thereof, concerning termination of proceedings:

Yes  ( ),  date and references              No ( )			 Not Known ( )

24. Penalties imposed (administrative and/or judicial):

25. Additional observations: 

For the IA
Prepared by:		Approved by:		
Office:		Office:		
Signature:		Signature:		
Date:		Date:		

For the NF
Prepared/
Checked by:		Approved by:		
Office:		Office:		
Signature:		Signature:		
Date:		Date: